Patterns of pelvic and acetabular injury among Sudanese patients.

Abstract

Background: Most of major pelvic fractures result from very high energy trauma and require urgent hospital treatment. However more minor, stable fractures may only require a period of rest and analgesia followed by gradual mobilization. Extended civil development and increased means of transportation in Sudan during the last two decades led to an increase in the number of highly potentiated traumatic accidents including isolated or combined pelvic and acetabular injuries. For this reason a unit for pelvic surgery has been established in Khartoum north teaching hospital in 2006. Objectives: A prospective study designed to evaluate the various patterns of pelvic and acetabular injuries in Khartoum North Teaching Hospital. Material and Methods: Patients with pelvic ring and acetabular injuries treated in Khartoum North Teaching Hospital, Khartoum, Sudan, between August 2006 and September 2009 were enrolled in the study. The collected data had been managed statistically using the appropriate SPSS computer package. Results: Hundred ten patients were included in the study. There were eighty one males. The mean age (± SEM) was 36.6 ±1.61 years. The cause of injury was a road traffic accident in 89 patients, a fall from height in ten patients, a fall at home in three patients and in eight patients due to miscellaneous cause. Forty four (40%) patients presented directly to our hospital, whereas, 66 (60%) patients referred from other various hospitals from different region of Sudan. The average hospital stay (± SEM) was 16.12 ±1.09 days. Regarding pattern of fractures; pelvis only was 59.1%, acetabulum only was 25.5%, and combined pelvic and acetabular fracture was 15.5%. According to Tile’s classification of pelvic and acetabular injuries there were 25 (22.7%) patients with type C1 pelvis, 18 (16.4%) with type A2 pelvis, 15 (13.6%) with type A1 acetabulum, three 2.7% with type A2 pelvis and A1 acetabulum, and three 2.7% with type C1 pelvis & A3 acetabulum injuries. Thirty seven patients had associated skeletal fractures and 12 patients had extra-skeletal injuries. Conclusion: Pelvic and acetabular injuries remain relatively uncommon in Sudan when compared with other musculoskeletal injuries. But our study showed that there is a continuous increase in the number of pelvic and acetabular injuries. So, many pelvic surgery units are needed to be established to cover many areas in Sudan to overcome the delay factor which may affect management outcome. 

Keywords: Pelvic fracture; Acetabular fracture; Tile’s classification; AO group classification.